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HomeMy WebLinkAbout2022 Sign off Transmittal - Replace deck with 3 season room TOWN OF YARMOUTH ce. HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. Building Site Location: 1 v VV' \� 3 2 /L' 'C fr Proposed Improvement: 44 3 S z;tel', f5 Applicant: //l LI r /1-5{/-i ( Tel. No.: - 9 . 2.5-0 1 Address:/6S— % C rJ 2/(fH pi; C) 2 3 2 c-/ Date Filed: ti-).C.--.17 **/f you would like e-mail notification of sign off, please provide e-mail address: ;i)j0 7 LJ e/ aiV: Owner Name: K--4)L �z(1 2yj l p ( Owner Address: I c� tAk 1 {; i 2 zl/tom ()-r Owner Tel. No.: L)/3 ' o Z1 b 13 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; 6 Mil Floor plan labeling ALL rooms within building APR 2 (all existing and proposed) — HEp,LTH DEPT Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: DATE: —' ` ^)-' PLEASE NOTE COMMENTS/CONDITIONS: • •••••••:=:: :• - .i. - . - - - • 1�',J•• .N • -Pull C • : • • • • • .1k <- ..- : '.� • - • : .. -i • . •. :, IW.ir . • . • ' - 'I .• W1 < •_ -• .. • • ... . . - • • ' ....•,......._. .... • -4.,..--..::••••• '- - • • -`•+'•..-;.•- ,-- -• ' - Y •om ... : - -----ti . 1. V: • .-- ' _1 ', " j : "_-%)/ . 7,.aft- -1 . � "I _ .` . - .1 . - •Q/ ri - ' '- . . . . �. i may ` : �. -. ` .. . ' • -•••2' 61/:: : -• {r{-� _ ... :. . . . . : . - i _kyr �' _ls • - �;•^'•y; . _ .. I •1 • • .. t... . w • • • -•.• - -71- . - •••••r --